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Hypocalcaemia following total thyroidectomy: early post-operative parathyroid hormone assay as a risk stratification and management tool.

Islam, Shofiq and Al Maqbali, T and Howe, D J and Campbell, J (2014) Hypocalcaemia following total thyroidectomy: early post-operative parathyroid hormone assay as a risk stratification and management tool. The Journal of laryngology and otology, 128 (3). pp. 274-8. ISSN 1748-5460.

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Abstract

OBJECTIVE

To develop a practical, efficient and predictive algorithm to manage potential or actual post-operative hypocalcaemia after complete thyroidectomy, using a single post-operative parathyroid hormone assay.

METHODS

This paper reports a prospective study of 59 patients who underwent total or completion thyroidectomy over a period of 24 months. Parathyroid hormone levels were checked post-operatively on the day of surgery, and all patients were evaluated for hypocalcaemia both clinically and biochemically with serial corrected calcium measurements.

RESULTS

No patient with an early post-operative parathyroid hormone level of 23 ng/l or more (i.e. approximately twice the lower limit of the normal range) developed hypocalcaemia. All the patients who initially had post-operative hypocalcaemia but had an early parathyroid hormone level of 8 ng/l or more (i.e. approximately two-thirds of the lower limit of the normal range) had complete resolution of their hypocalcaemia within three months.

CONCLUSION

Early post-operative parathyroid hormone measurement can reliably predict patients at risk of post-thyroidectomy hypocalcaemia, and predict those patients expected to recover from temporary hypocalcaemia. A suggested post-operative management algorithm is presented.

Item Type: Article
Subjects: WK Endocrine system. Endocrinology
Divisions: Ambulatory Care > ENT
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Depositing User: Mrs Yolande Brookes
Date Deposited: 19 Aug 2014 10:05
Last Modified: 19 Aug 2014 10:05
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/533

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